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Objective@#The study aims to explore the neural mechanism of cognitive differences in college students with posttraumatic stress disorder under verbal fluency task based on functional near infrared spectroscopy (fNIRS), so as to provide neuroimaging support for the evaluation, diagnosis and treatment of posttraumatic stress disorder(PTSD).@*Methods@#Posttaumatic Stress Disorder Checklist Combat(PCL-C) was used to screen the subjects, including 21 students in PTSD group (PCL-C≥38) and 30 students in control group from September to Novenber in 2020. A 53 channel near infrared spectroscopy device was used to collect cerebral blood oxygen signals under the verbal fluency task, and correlation analysis, Mann Whitney U test and independent sample t test were performed on the results.@*Results@#The difference in the total average score of PCL-C Scale between PTSD group and the control group(46.38±6.96,25.57±6.09) was statistically significant ( t=11.33, P <0.05). Correlation analysis showed that Avg-HbO in left dorsolateral prefrontal lobe was negatively correlated with PCL-C Score ( r=-0.37, P <0.05). Mann Whitney U test showed that in the left dorsolateral prefrontal lobe (Ch6), the Avg-HbO change in PTSD group [0.19(-0.09, 0.86)mmol/(L〖KG*7〗·mm)] was significantly lower than the control group [0.79( 0.37 , 1.47)mmol/(L ·mm)] ( Z=2.16, P <0.05), which was statistically significant.@*Conclusions@#The degree of PTSD was negatively correlated with the index of oxygenated hemoglobin in the left dorsolateral prefrontal lobe, and the oxygenated hemoglobin content in the PTSD group was lower than that in the normal group. In the future, fNIRS may be used to collect blood oxygen signals from the left dorsolateral prefrontal lobe in cognitive tasks to provide imaging evidence for the identification of PTSD.
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Objective To investigate whether salvianolic acid B(Sal B)can improve the cognitive function in rats with post-traumatic stress disorder(PTSD)by regulating GSK-3β/β-Catenin signal pathway.Methods Sixty rats were randomly grouped into the normal group,the PTSD group,the Sal B low-dose group(10 mg/kg),the Sal B high-dose group(20 mg/kg)and the GSK-3β inhibitor group(30 mg/kg CHIR-99021),with 12 rats in each group.In addition to the normal group,rats in other groups were constructed PTSD rat models by using single prolonged stress(SPS)method.Open field test and Morris water maze test were applied to evaluate the cognitive function of rats.Nissl staining was applied to observe the pathological changes of hippocampal neurons.TUNEL staining was applied to detect the apoptosis of hippocampal neurons.Western blot assay was applied to detect the expression of cleared caspase-3,B-cell lymphoma gene-2-associated X protein(Bax),proto-oncogene(c-Myc),Cyclin D1,total GSK-3β(t-GSK-3β),phosphorylated GSK-3β(p-GSK-3β),total β-Catenin(t-β-Catenin)and phosphorylated β-catenin(p-β-Catenin)proteins in hippocampus.Results Compared with the PTSD group,the number of crawling spaces,standing times,total movement distance and times of crossing the original platform of rats were higher in the Sal B low-dose group,the Sal B high-dose group and the GSK-3β inhibitor group.The escape latency and the time to cross the original platform for the first time were shorter,the apoptosis rate of hippocampal neurons and the expression levels of Bax,cleaved caspase-3,t-GSK-3β and p-β-Catenin proteins in hippocampus were lower,and the expression levels of Cyclin D1,c-Myc,p-GSK-3β,t-β-Catenin proteins were higher(P<0.05).Conclusion Sal B can reduce the apoptosis and damage of hippocampal neurons in rats with PTSD and improve cognitive dysfunction in rats,and inhibit the GSK-3β/β-Catenin signal pathway.
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ABSTRACT Objective: To understand the meaning attributed by women with physical disabilities to the health care received and expected during labor and delivery. Methods: Qualitative study, based on Social Network Theory, conducted through an online workshop in April 2022, with the participation of six women with physical disabilities. Data, collected through the focus group technique, underwent thematic content analysis with the assistance of the IRaMuTeQ tool. Results: Three thematic categories emerged: Challenges experienced during pregnancy; The experience within the maternity ward; and, The importance of social networks. The assistance provided by healthcare professionals sometimes differed between what was expected and what was received by women with physical disabilities during labor and delivery. Final Considerations: Experiences were predominantly negative, resulting from inappropriate professional conduct due to ableist attitudes. Support from members of social networks is crucial for preventing stressors.
RESUMEN Objetivo: Comprender el significado atribuido por mujeres con discapacidad física a la asistencia de salud recibida y esperada durante el trabajo de parto y parto. Métodos: Estudio cualitativo, fundamentado en la Teoría de Redes Sociales, llevado a cabo mediante un taller en línea en abril de 2022, con la participación de seis mujeres con discapacidad física. Los datos, recopilados mediante la técnica de grupo focal, fueron sometidos a análisis de contenido temático con la ayuda de la herramienta IRaMuTeQ. Resultados: Emergieron tres categorías temáticas: Problemas experimentados durante el embarazo; La experiencia dentro de la maternidad; y La importancia de las redes sociales. La asistencia proporcionada por los profesionales de la salud, en ocasiones, difirió entre lo esperado y lo recibido por las mujeres con discapacidad física durante el trabajo de parto y parto. Consideraciones finales: Las experiencias fueron predominantemente negativas, resultado de conductas profesionales inadecuadas debido a actitudes capacitistas. El apoyo de los miembros de las redes sociales es fundamental para la prevención de factores estresores.
RESUMO Objetivo: Compreender o significado atribuído por mulheres com deficiência física à assistência de saúde recebida e esperada durante o trabalho de parto e parto. Métodos: Estudo qualitativo, fundamentado na Teoria de Rede Social, realizado por meio de uma oficina online em abril de 2022, com a participação de seis mulheres com deficiência física. Os dados, coletados por meio da técnica de grupo focal, foram submetidos à análise de conteúdo temático com o auxílio da ferramenta IRaMuTeQ. Resultados: Três categorias temáticas emergiram: Problemas vivenciados na gravidez; A experiência dentro da maternidade; e A importância das redes sociais. A assistência prestada pelos profissionais de saúde, por vezes, diferiu entre o esperado e o recebido pelas mulheres com deficiência física durante o trabalho de parto e parto. Considerações Finais: As vivências foram predominantemente negativas, resultantes de condutas profissionais inadequadas devido a atitudes capacitistas. O apoio dos membros das redes sociais é fundamental para a prevenção de fatores estressores.
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Objective@#To investigate the characteristics of post traumatic stress disorder (PTSD) in college students during the outbreak of COVID-19, and to explore the mediating role of psychological resilience between social support and PTSD.@*Methods@#By using direct selection method, 572 college students in Anhui and Shanghai were selected and administered with General Characteristics Questionnaire, the PTSD Checklist Civilian Version(PCL-C), Psychological Resilience Scale(PRS) and Social Support Rating Scale(SSRS).@*Results@#Among the participants, 25.0% had moderate PTSD symptoms, 11.7% had obvious PTSD symptoms, and the positive rate of PTSD was 36.7%. The prevalence of PTSD in college students was higher in males than in females ( χ 2= 4.31, P <0.05). The junior students were higher than other students ( χ 2=16.81, P <0.01). The scores of social support, psychological resilience and PTSD were (33.79±4.83), (92.17±13.39) and (35.50±11.39), respectively. The correlations of all variables were statistically significant( r =-0.49-0.76, P <0.05); The mediation test showed that social support could not only negatively predict PTSD directly(direct effect was -0.35), but also indirectly affect PTSD through psychological resilience(indirect effect was -0.32).@*Conclusion@#More than one third of college students have PTSD symptoms, and psychological resilience plays a partial mediating role in the relationship between social support and PTSD,social support can both directly and negatively predict PTSD and indirectly affect PTSD by increasing an individual s psychological resilience.
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ABSTRACT Objective: COVID-19 has been associated with a significant burden to those who survive the acute phase. We aimed to describe the quality of life and symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) at 90 days after hospital discharge of COVID-19 patients. Methods: Patients with COVID-19 admitted to a private hospital in the city of São Paulo, Brazil, between April of 2020 and April of 2021 were interviewed by telephone at 30 and 90 days after discharge to assess the quality of life and symptoms of depression, anxiety, and PTSD. Results: A total of 2,138 patients were included. The mean age was 58.6 ± 15.8 years, and the median length of hospital stay was 9.0 (5.0-15.8) days. Between the two time points, depression increased from 3.1% to 7.2% (p < 0.001), anxiety increased from 3.2% to 6.2% (p < 0.001), and PTSD increased from 2.3% to 5.0% (p < 0.001). At least one physical symptom related to COVID-19 diagnosis persisted in 32% of patients at day 90. Conclusions: Persistence of physical symptoms was high even at 90 days after discharge. Although the prevalence of symptoms of anxiety, depression, and PTSD was low, these symptoms persisted for three months, with a significant increase between the time points. This finding indicates the need to identify at-risk patients so that they can be given an appropriate referral at discharge.
RESUMO Objetivo: A COVID-19 tem sido associada a um fardo significativo para aqueles que sobrevivem à fase aguda. Nosso objetivo foi descrever a qualidade de vida e sintomas de ansiedade, depressão e transtorno de estresse pós-traumático (TEPT) 90 dias após a alta hospitalar em pacientes com COVID-19. Métodos: Pacientes com COVID-19 internados em um hospital privado na cidade de São Paulo (SP) entre abril de 2020 e abril de 2021 foram entrevistados por telefone 30 e 90 dias após a alta para avaliar a qualidade de vida e sintomas de depressão, ansiedade e TEPT. Resultados: Foram incluídos 2.138 pacientes. A média de idade foi de 58,6 ± 15,8 anos, e a mediana do tempo de internação hospitalar foi de 9,0 (5,0-15,8) dias. Entre os dois momentos, a depressão aumentou de 3,1% para 7,2% (p < 0,001), a ansiedade, de 3,2% para 6,2% (p < 0,001), e o TEPT, de 2,3% para 5,0% (p < 0,001). Pelo menos um sintoma físico relacionado ao diagnóstico de COVID-19 persistia em 32% dos pacientes no 90º dia. Conclusões: A persistência dos sintomas físicos foi elevada mesmo 90 dias após a alta. Embora a prevalência de sintomas de ansiedade, depressão e TEPT tenha sido baixa, esses sintomas persistiram por três meses, com aumento significativo entre os momentos. Esse achado indica a necessidade de identificar os pacientes de risco para que possam receber o encaminhamento adequado no momento da alta.
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Resumo: Introdução: Os universitários de Ciências da Saúde se tornaram especialmente afetados pela pandemia do vírus Sars-CoV-2. As angústias intrinsicamente relacionadas à Covid-19 foram somadas aos impactos referentes às mudanças acontecidas nas instituições acadêmicas, particularmente a mudança para o ensino on-line, uma metodologia que pode gerar desconforto aos estudantes, além de vários obstáculos relacionados ao ensino e à aprendizagem, o que pode ter repercussões traumáticas importantes na saúde mental dessa população. Objetivo: Este estudo teve como objetivo verificar a carga mental provocada pela pandemia da Covid-19, como um evento traumático ao ponto de desencadear transtornos psiquiátricos, como o transtorno do estresse pós-traumático (Tept), em universitários. Método: Trata-se de um estudo transversal e quantitativo, com orientação analítico-descritiva, mediante preenchimento de formulário digital anônimo, iniciado após prévia aprovação do Comitê de Ética em Pesquisa. Os sujeitos foram estudantes de Ciências Biológicas e da Saúde de uma universidade estadual localizada na Região Sudeste do Brasil. A amostra foi constituída por 618 estudantes. Resultado: Foram respondidos 618 formulários pelos estudantes que pertenciam aos cursos de Educação Física (28,8%), Medicina (25,4%), Odontologia (18,1%), Ciências Biológicas (15,2%) e Enfermagem (12,5%). A presença de sintomas de estresse pós-traumático verificados pela Escala de Impacto do Evento-Revisada (IES-R) obteve prevalência de 32,7% (n = 202) entre os estudantes universitários das Ciências Biológicas e da Saúde. Conclusão: Houve impacto significativo na saúde mental dos universitários com presença de sintomas depressivos, ansiedade e estresse acima dos encontrados na literatura científica, e, consequentemente, constatou-se alta na prevalência do Tept.
Abstract: Introduction: Health Sciences university students were especially affected by the Sars-CoV-2 virus pandemic. The anxieties intrinsically related to Covid-19 were added to the impacts related to the changes that have taken place in academic institutions, particularly the change to online teaching, a methodology that can generate discomfort for students, in addition to several obstacles related to teaching and learning, which can have important traumatic effects on the mental health of this population. Objective: To assess the mental health burden caused by the COVID-19 pandemic, as a traumatic event capable of triggering psychiatric disorders, such as Post-Traumatic Stress Disorder (PTSD), in university students. Methods: This is a cross-sectional and quantitative study, of analytical-descriptive nature, carried out by filling out an anonymous digital form, initiated after prior approval by the Research Ethics Committee. The subjects were students of Biological and Health Sciences at a State University located in the southeastern region of Brazil. The sample consisted of 618 students. Results: 618 forms were answered by students attending the courses of Physical Education (28.8%), Medicine (25.4%), Dentistry (18.1%), Biological Sciences (15.2%) and Nursing (12.5%). The presence of post-traumatic stress symptoms assessed by the Impact of Event Scale - Revised (IES-R) obtained a prevalence of 32.7% (n = 202) among university students from Biological and Health Sciences courses. Conclusions: There was a significant impact on the mental health of university students, with the presence of depressive symptoms, anxiety and stress above those found in the scientific literature and, consequently, a high prevalence of PTSD.
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Post-traumatic stress disorder (PTSD) is a psychiatric illness induced by exposure to severe stress-induced traumatic events. Repeated traumatic re-experience, avoidance, negative cognition and emotional changes seriously reduce the quality of life of PTSD patients. Currently, it is urgent to further clarify the etiology and molecular mechanism of PTSD in order to guide the diagnosis and treatment of PTSD. Considering the underlying pathophysiology is not entirely known, to identify the pertinent biomarkers of PTSD is critical in researching its incidence and progression. In contrast with the single-omics researches, multi-omics studies may methodically expand on biomolecular interactions from a range of angles, creating a new potential to comprehend the development of complicated human illnesses. Therefore, the authors review the research progress in PTSD biomarkers from aspects of genomics, transcriptomics and proteomics, hoping to provide a reference for future research and treatment of PTSD.
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Posttraumatic stress disorder (PTSD), the most common mental illness after patients suffer physically or emotionally from traumatic events, can cause persistently strong, painful and terrible avoidance symptoms, emotional and cognitive changes, causing psychologically strong stimulation and heavy burden to patients and even leading to some extreme behavioral reactions. Traumatic brain injury (TBI) is an important factor in the occurrence of PTSD, both of which shares many similar pathological overlaps, and may coexist and interact with each other. The hippocampus and amygdala play a central role in the pathogenesis of PTSD, but the specific cellular and molecular and neural circuit mechanisms are still unclear. About two-thirds of the patients still meet the diagnostic criteria for PTSD after psychotherapy. However, the current treatment methods are complicated and not unified, and patients treated with medications may have adverse drug reactions, poor treatment outcomes and recurrence. Therefore, it is of great significance to further clarify the occurrence and development of PTSD in TBI patients. The authors reviewed the research progress of the pathogenesis and treatment of PTSD in TBI patients, so as to provide reference for the related research and treatment of PTSD in TBI patients.
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OBJETIVOS: Determinar os fatores associados ao transtorno de estresse pós-traumático (TEPT) e verificar a correlação com a qualidade de vida (QV) em mulheres com queimaduras profundas. MÉTODO: Estudo de corte transversal, realizado em um hospital de referência para queimados na Região Nordeste do Brasil. Foram incluídas 50 mulheres adultas com mais de 20 anos, que sofreram queimaduras profundas e estavam em tratamento ambulatorial de reabilitação. Foram aplicados os questionários das variáveis sociodemográficas e clínicas e instrumentos para verificar a QV, Burn Specific Health Scale-Revised-BSHS-R, e o TEPT, o Impact of Event Scale-IES. Para análise estatística, foi usado o teste t de Student e também os modelos de regressão linear simples e múltipla. RESULTADOS: Observou-se uma média do escore IES menor estatisticamente quando o índice de massa corporal < 30kg/m2 e maior quando a renda familiar mensal <1 salário-mínimo, o tempo de fisioterapia < 6 meses e diante da necessidade de utilização de órtese. Exceto o domínio de habilidades funcionais simples do questionário BSHS-R, para os demais domínios, incluindo o somatório total, encontrou-se uma correlação positiva entre os escore do IES e do BSHS-R. CONCLUSÕES: Obesidade, baixa renda familiar, menor tempo de fisioterapia e necessidade de uso de órtese, além da pior qualidade de vida, foram os fatores associados ao TEPT em mulheres com queimaduras profundas, sugerindo necessidade de políticas públicas específicas para essa população.
OBJECTIVES: To determine factors associated with post-traumatic stress disorder (PTSD) and actively check with quality of life (QoL) in women with deep burns. METHODS: Cross-sectional study, carried out in a reference hospital for burns in the northeast region of Brazil. Fifty adult women over 20 years old who had suffered deep burns and were undergoing outpatient rehabilitation treatment were included. The experimental variables of sociodemographic and clinical variables and instruments were applied to verify QoL, Burn Specific Health Scale-Revised-BSHS-R, and PTSD, Impact of Event Scale-IES. For statistical analysis, Students t test was used, as well as simple and multiple linear regression models. RESULTS: A statistically lower average IES score was observed when the body mass index < 30kg/m2 and higher when the monthly family income < 1 minimum wage, the time of physiotherapy < 6 months and in view of the need to use an orthosis. Except for the simple skills domain of the BSHS-R, for the other domains, including the total sum, a positive correlation was found between the IES and BSHS-R scores. CONCLUSIONS: Obesity, low family income, shorter physiotherapy time and the need to use an orthosis, in addition to a worse quality of life, were factors associated with PTSD in women with deep burns, suggesting the need for specific public policies for this population.
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RESUMEN Introducción: La hospitalización a causa de la COVID-19 puede predisponer a la aparición de posibles secuelas psicológicas a largo plazo. Objetivo: Determinar la relación entre los factores hospitalarios y no hospitalarios con el estrés postraumático en pacientes con alta médica por la COVID-19. Métodos: Estudio de corte transversal y diseño correlacional. La muestra no probabilística estuvo compuesta por 126 participantes con la COVID-19, evaluados mediante un cuestionario autoadministrado y la Escala de Trauma de Davidson. Para el procesamiento de datos se aplicó la prueba ji cuadrado y la V de Cramer como medida de magnitud de efecto. Resultados: El trastorno por estrés postraumático presenta asociaciones moderadas con los factores hospitalarios: tiempo de hospitalización (p< 0,001) (V de Cramer= 0,33), tipo clínico de COVID-19 (p< 0,001) (V de Cramer= 0,49) y soporte ventilatorio invasivo (p< 0,001) (V de Cramer= 0,39); y con los factores no hospitalarios: oxigenoterapia en rehabilitación (p< 0,001) (V de Cramer= 0,33), secuelas neurológicas (p< 0,001) (V de Cramer= 0,41), dificultad respiratoria (p< 0,001) (V de Cramer= 0,53), percepción de discriminación social (p< 0,05) (V de Cramer= 0,29), dificultad para reincorporarse a las actividades diarias (p< 0,001) (V de Cramer= 0,40) y familiares infectados con la COVID-19 (p< 0,001) (V de Cramer= 0,30). Conclusiones: Existen factores, tanto intra como extrahospitalarios, que se relacionan con el trastorno por estrés postraumático luego del alta médica por la COVID-19.
ABSTRACT Introduction: Hospitalization due to COVID-19 can predispose to the appearance of possible long-term psychological sequelae. Objective: To determine the relationship between hospital and non-hospital factors with post-traumatic stress in patients discharged for COVID-19 from a hospital in Peru. Methods: Cross-sectional study and correlational design. The non-probabilistic sample consisted of 126 participants, evaluated through a self-administered questionnaire and the Davidson Trauma Scale. For data processing, the chi-square test and Cramer's V were used as measures of the magnitude of effect. Results: Post-traumatic stress disorder presents moderate associations with hospital factors: hospitalization time (p<0.001) (Cramer's V = 0.33), clinical type of COVID-19 (p<0.001) (Cramer's V = 0 .49) and invasive ventilatory support (p<0.001) (Cramer's V = 0.39); and with non-hospital factors: oxygen therapy in rehabilitation (p<0.001) (Cramer's V = 0.33), neurological sequelae (p<0.001) (Cramer's V = 0.41), respiratory distress (p<0.001) (Cramer's V = 0.53), perception of social discrimination (p<0.05) (Cramer's V = 0.29), difficulty returning to daily activities (p<0.001) (Cramer's V = 0.40) and family members infected with COVID-19 (p<0.001) (Cramer's V = 0.30). Conclusions: There are both in-hospital and out-of-hospital factors associated with post-traumatic stress disorder following discharge from COVID-19.
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Resumo Objetivo Analisar a prevalência estimada do Transtorno do Estresse Pós-Traumático em profissionais emergencistas e seus fatores relacionados. Métodos Estudo analítico, transversal, exploratório com abordagem quantitativa, realizado em serviços de referência no atendimento a urgências e emergências em saúde e em serviços de segurança e proteção pública com condutores socorristas, enfermeiros, técnicos/auxiliares de enfermagem, médicos, policiais e bombeiros militares. Foram analisados dados provenientes de dois instrumentos. As classificações da Escala do Impacto do Evento - Revisada foram relacionadas com as variáveis sociodemográficas, profissionais e de aspectos relativos ao evento potencialmente traumático coletadas na amostra, e foi levantada a prevalência dos eventos potencialmente traumáticos. Resultados Participaram 338 profissionais, 31,07% apresentaram escores compatíveis com provável diagnóstico da psicopatologia. Apresentaram escores correspondentes ao agravo 39,67% dos profissionais de segurança e 20,78% dos de saúde. Os profissionais de segurança tiveram prevalência 48% superior na apresentação de escores compatíveis com o diagnóstico do transtorno. Como fatores relacionados, foram identificados os eventos potencialmente traumáticos prevalentes na amostra, usualmente relativos a situações com risco de morte, e estratégias de enfrentamento, que apontaram relação significativa com os escores do transtorno, como o afastamento de situações semelhantes, o suporte psicológico e reavaliação das situações. Conclusão O risco encontrado foi relativamente alto quando comparado a outros estudos brasileiros; situações envolvendo risco à vida foram prevalentes e as estratégias de enfrentamento com relações significativas se encontraram nos participantes que optaram pelo afastamento, suporte psicológico e reavaliação das situações potencialmente traumáticas.
Resumen Objetivo Analizar la prevalencia estimada del trastorno del estrés postraumático en profesionales de emergencias y los factores relacionados. Métodos Estudio analítico, transversal, exploratorio con enfoque cuantitativo, realizado en servicios de referencia en la atención a urgencias y emergencias de salud y en servicios de seguridad y protección pública con conductores socorristas, enfermeros, técnicos/auxiliares de enfermería, médicos, policías y bomberos militares. Se analizaron los datos provenientes de dos instrumentos. Se relacionaron las clasificaciones de la Escala del Impacto del Evento - Revisada con las variables sociodemográficas, profesionales y de aspectos relativos al evento potencialmente traumático recopiladas en la muestra. Además, se estudió la prevalencia de los eventos potencialmente traumáticos. Resultados Participaron 338 profesionales, el 31,07 % presentó puntuación compatible con un probable diagnóstico de la psicopatología. El 39,67 % de los profesionales de seguridad y el 20,78 % de los de salud presentaron puntuación que correspondía al empeoramiento. Los profesionales de seguridad tuvieron una prevalencia 48 % superior en la presentación de puntuación compatible con el diagnóstico del trastorno. Como factores relacionados, se identificaron los eventos potencialmente traumáticos prevalentes en la muestra, normalmente relativos a situaciones con riesgo de muerte, y las estrategias de afrontamiento que indicaron una relación significativa con la puntuación del trastorno, como el evitar situaciones semejantes, el apoyo psicológico y la revaluación de las situaciones. Conclusión El riesgo encontrado fue relativamente alto en comparación con otros estudios brasileños. Las situaciones con riesgo de vida fueron prevalentes. Se observaron estrategias de afrontamiento con relaciones significativas en participantes que optaron por el distanciamiento, el apoyo psicológico y la revaluación de las situaciones potencialmente traumáticas.
Abstract Objective To analyze the estimated prevalence of Post-Traumatic Stress Disorder in emergency professionals and its related factors. Methods Analytical, cross-sectional, exploratory, quantitative study performed in reference services in urgent and emergency care in health and services of public safety and protection with emergency service drivers, nurses, nursing technicians/assistants, physicians, police officers and firefighters. Data from two instruments were analyzed. The classifications of the Event Impact Scale - Revised were related to sociodemographic and professional variables and to those of aspects related to the potentially traumatic event collected in the sample. The prevalence of potentially traumatic events was estimated. Results Participation of 338 professionals, of which 31.07% had compatible scores with a probable diagnosis of the psychopathology, and 39.67% of security professionals and 20.78% of health professionals had scores corresponding to the disorder. Security professionals had a 48% higher prevalence of compatible scores with diagnosis of the disorder. The potentially traumatic events prevalent in the sample were identified as related factors, usually the situations with risk of death and coping strategies, which showed a significant relationship with scores of the disorder, such as distancing from similar situations, psychological support and reassessment of situations. Conclusion The risk was relatively high when compared to other Brazilian studies; situations involving risk to life were prevalent and the coping strategies with significant relationships were found in participants who chose distancing, psychological support and reassessment of potentially traumatic situations.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Trastornos por Estrés Postraumático/epidemiología , Personal de Salud , Urgencias Médicas , Métodos de Análisis de Laboratorio y de Campo , Estudios de Evaluación como AsuntoRESUMEN
Objective:To investigate the effects of esketamine on the behavior of post-traumatic stress disorder(PTSD).Methods:Thirty-six adult male SD rats were randomly divided into three groups. The mouse craniocerebral trauma model was established by cortical impact injury method. The Sham group ( n=12) only opened the bone window without craniocerebral trauma. The TBI group( n=12) and the TBI+ ES group( n=12) were subjected to cortical trauma; Immediately after trauma, the TBI+ ES group was intraperitoneally injected with esmketamine (10 mg/kg, once every two hours, three times in total), and the TBI group and Sham group were intraperitoneally injected with equal volume 0.9% sodium chloride solution. The results of sugar water preference test, open field test on day 16 and elevated cross maze test on day 17 were collected to analyze PTSD like behavior changes, and Morris water maze test was used to evaluate the learning and memory ability of rats in each group from day 18 to 23 after craniocerebral trauma. After the experiment, the rats were euthanized and the brain tissues were taken. The expression levels of brain-derived neurotrophic factor (BDNF), synaptic protein PSD95 and synaptophysin (Syp) were analyzed by Western blot. The measurement data of normal distribution were expressed as mean ± standard deviation ( ± s). One way ANOVA was used for multi group comparison, SNK- q test was used for post pairwise comparison, and LSD method was used for repeated measurement data. Results:In the TBI group, the preference rate of sugar water, the number of moving grids, the number of standing upright, the residence time of open arm, the number of open arm entry, the escape latency and the number of crossing platform [(75.8±4.9)%, (30.9±4.1) grids, (12.4±2.6) times, (40.3±8.5) s, (6.8±2.3) times, (30.0±4.6) s and (7.0±2.5) times] were significantly lower than Sham group [(85.3±4.4)%, (40.5±5.4) grid, (17.3±2.7) times, (95.8±12.4) s, (15.3±3.1) times, (18.3±7.8) s, (15.7±2.6) times] ( P< 0.05); In TBI+ ES group, the sugar water preference rate, the number of moving grids, the number of upright times, the time of open arm stay, the number of open arm entry, the number of escape latency and the number of crossing platform position [(82.9±5.5)%, (35.5±5.5) grids, (15.1±2.4) times, (68.4±9.7) s, (12.1±3.2) times, (22.3±8.8) s and (12.5±4.1) times] were significantly higher than those in TBI group ( P<0.05). The expression levels of BDNF, PSD95 and Syp in TBI+ ES Group [0.43±0.08), (0.22±0.02), (0.31±0.04)] were higher than those in TBI group [0.19±0.02), (0.20±0.02), (0.24±0.01)], the difference was significant ( P<0.05), and they were lower than those in Sham group [0.89±0.11), (0.45±0.12), (0.57±0.15)], and the difference was significant ( P<0.05). Conclusion:Esticketamine significantly reduce PTSD-like behavior in TBI rats and play a neuroprotective role, which may be a potential medicinefor PTSD treatment.
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Objective:To investigate the application of system relaxation training on the posttraumatic stress disorder for the families of burned children, so as to provide a basis for the application of valid nursing in children families.Methods:A total of 80 cases of burned children in Children′s Hospital of Nanjing Medical University and corresponding 80 households were recruited and divided into the observation group and the control group with 40 cases each group. The patients and households from January 2019 to May 2019 in the control group received routine care, while the patients and households from February 2020 to June 2020 in the observation group received system relaxation training based on the routine care for four days. The posttraumatic stress disorder and uncertainty in illness of children families before and after intervention were evaluated by Posttraumatic stress Checklist-Civilian version(PLC-C) and Mishel Uncertainty in Illness Scale-Family Member form(MUIS-FM) and compared between the two groups.Results:There was no significant difference in the scores of PLC-C and MUIS-FM before intervention in the households between the two groups( P>0.05). After intervention, the scores of re-experiencing symptoms, avoidance/numbing, increased arousal symptoms and total PTSD scores in the households were (8.40 ± 1.79), (14.35 ± 2.85), (8.25 ± 1.28), (31.10 ± 3.52) points in the observation group and (11.28 ± 2.37), (16.75 ± 2.09), (9.10 ± 1.93), (37.13 ± 4.40) points in the control group, the differences were statistically significant ( t values were -6.76 - -2.32, all P<0.05). After intervention, the scores of ambiguity, deficit information and total MUIS-FM scores of the households were (37.08 ± 6.58), (20.15 ± 4.38), (84.38 ± 6.90) points in the observation group and (41.13 ± 6.54), (22.05 ± 3.32), (90.13 ± 7.85) points in the control group, the differences were statistically significant ( t =-2.76, -2.19, -3.48, all P<0.05). Conclusions:System relaxation training can alleviate posttraumatic stress disorder and reduce uncertainty in illness of the families of burned children.
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Abstract@#Deviant behaviors among adolescents is widespread and have substantial impacts on family and society. Increasing evidence has shown that adolescents who experienced traumatic stress events and suffered from post traumatic stress disorder are at significantly higher risk of deviant behaviors than their healthy peers and have their personal lives negatively affected. In this review, the effect of PTSD on deviant behaviors in adolescents is summarized, in which adolescent deviant behaviors are mainly classified into extroverted, introverted, and academic deviant behavior, as well as deviant habits. Meanwhile, aims to explore the neural mechanism linking PTSD and adolescent deviant behaviors, and to provide suggestions for intervention of deviant behaviors.
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Objective:To understand the incidence of post-traumatic stress disorder(PTSD) in fathers with premature infants and analyze the risk factors.Methods:Conveniently, the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire, Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition (PPQ-C), Parents, Perception of Uncertainty Scale, Social Support Rating Scale, Simplified Coping Style Questionnaire. Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model. ROC curve was used to verify the discrimination ofthe model. Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results:PPQ-C total score of 203 fathers was 17.17 ± 8.77, 81 fathers, symptoms were positive and the incidence of PTSD was 39.90%(81/203). Logistic regression analysis showed college degree ( OR = 0.297, 95% CI 0.116 - 0.763, P<0.05), very low birth weight ( OR = 2.491, 95% CI 1.027 - 6.044, P<0.05), sense of disease uncertainty ( OR = 1.038, 95% CI 1.012 - 1.066, P<0.05), negative coping style ( OR = 1.871, 95% CI 1.127 - 3.108, P<0.05) were risk factors of PTSD in fathers with premature infants. The nomogram model was established basing on the results of the Logistic regression analysis, and the ROC curve proved (AUC = 0.751) the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test ( P = 0.974) and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values. Conclusions:A higher incidence of PTSD was observed in fathers with hospitalized premature infant. It was related to education level, the infants′s birth weight, disease uncertainty and coping style. Therefore, the nurses should give information support and psychological guidance according to the individual situation of the infants′ father to reduce the incidence of PTSD.
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Objective:To evaluate the effects of dexmedetomidine on the enhancement of fear memory by propofol in rats with post-traumatic stress disorder (PTSD).Methods:Two hundred and twenty clean-grade healthy male Sprague-Dawley rats, weighing 300-400 g, aged 12-16 weeks, underwent conditioned fear memory training, and PTSD model was developed.One hundred and twenty rats were divided into 6 groups ( n=20 each) by a random number table method: control group (C group), PTSD group, propofol group (P1 group), and propofol + different doses of dexmedetomidine groups (P1+ DEX10 group, P1+ DEX20 group and P1+ DEX40 group). In group C, only sound was played and no electric shock was given during conditioned fear memory training.After conditioned fear memory training, sesame oil 1 ml/kg was intraperitoneally injected in PTSD group, propofol 1 ml/kg was intraperitoneally injected in group P1, and dexmedetomidine 10, 20 and 40 μg/kg were intraperitoneally injected in P1+ DEX10, P1+ DEX20 and P1+ DEX40 groups, respectively.After drug administration, conditioned fear memory test was performed to record the time of rigid behavior within 90 s, and the percentage of time of rigid behavior was calculated.The development of SpO 2<90% was recorded during administration.One hundred Sprague-Dawley rats were divided into 5 groups ( n=20 each) by the random number table method: propofol group (P2 group), and propofol+ dexmedetomidine given at different timings groups (P2+ DEX T0 group, P2+ DEX T30 group, P2+ DEX T60 group and P2+ DEX T90 group). After the conditioned fear memory training, propofol 1 ml/kg was intraperitoneally injected in 5 groups, an then dexmedetomidine 20 μg/kg was intraperitoneally injected at 0, 30, 60 and 90 min after propofol administration in P2+ DEX T0, P2+ DEX T30, P2+ DEX T60 and P2+ DEX T90 groups, respectively.Conditioned fear memory test was performed after drug administration to record the time of rigid behavior within 90 s, and the percentage of time of rigid behavior was calculated. Results:Only 6 rats developed SpO 2<90% during the administration period in P1+ DEX40 group.Compared with C group, the percentage of time of rigid behavior was significantly increased in PTSD group ( P<0.05). Compared with PTSD group, the percentage of time of rigid behavior was significantly increased in P1 group ( P<0.05). Compared with P1 group, the percentage of time of rigid behavior was significantly decreased in P1+ DEX20 and P1+ DEX40 groups ( P<0.05), and no significant change was found in the percentage of time of rigid behavior in P1+ DEX10 group ( P>0.05). Compared with P2 group, the percentage of time of rigid behavior was significantly decreased in P2+ DEX T0 and P2+ DEX T30 groups ( P<0.05), and no significant change was found in the percentage of time of rigid behavior in P2+ DEX T60 and P2+ DEX T90 groups ( P>0.05). Conclusions:Dexmedetomidine can attenuate propofol-induced enhancement of fear memory in a rat model of PTSD, and the best effect is achieved in early administration of moderate dose (20 μg/kg, within 30 min after propofol administration).
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ABSTRACT Objective: To assess the influence of oral and maxillofacial trauma on the development of Post-Traumatic Stress Disorder (PTSD) and to determine the efficiency of the Impact of Event Scale-Revised (IES-R) as a diagnostic tool for detecting PTSD in patients with Oral and Maxillofacial injuries. Material and Methods: PTSD was assessed one month postoperatively by the diagnostic instrument, IES-R, to arrive at a provisional diagnosis. A structured clinician-administered PTSD Scale then assessed the patients for the Diagnostic and Statistical Manual of Mental Disorders-5th edition (CAPS-5) to establish a final diagnosis. The assessment of the severity of PTSD was done based on various types of oral and maxillofacial injuries. Results: The IES-R scale provisionally diagnosed 54 subjects with PTSD, out of which 42 were diagnosed to have PTSD by the CAPS-5 scale. Subjects with injuries involving the 'orbital complex,' those presenting with a perceptible scar in the maxillofacial region and with multiple avulsed/ luxated anterior teeth, showed a higher affinity to develop PTSD, and this was statistically significant. Conclusion: Higher levels of PTSD in patients with injuries to the maxillofacial region warrants correct diagnosis and detection, and hence the maxillofacial surgeon plays a vital role in this regard. The IES-R is a useful diagnostic tool to detect PTSD early.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Trastornos por Estrés Postraumático/etiología , Diagnóstico Precoz , Cirujanos Oromaxilofaciales , Traumatismos Maxilofaciales/diagnóstico , Distribución de Chi-Cuadrado , Estudios Transversales/métodos , India/epidemiologíaRESUMEN
Objective@#To explore the relationship between an anti epidemic mentality and post traumatic stress disorder (PTSD) among college students during the corona virus disease 2019 (COVID-19) pandemic, and to provide a scientific basis for the prevention of PTSD when college students experience sudden crisis events in the future.@*Methods@#An online questionnaire survey was conducted among 9 399 undergraduates from Shanxi Medical University using the Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C) and the public anti epidemic psychology self examination scale.@*Results@#During the COVID-19 pandemic, the total PCL-C scores of college students were (22.74±7.78), and the positive rate of PTSD symptoms was 5.3%. The detection rates of symptom recurrence, avoidance/numbness symptoms and increased alertness symptoms were 27.0%, 16.6% and 8.6 %, respectively. The average score of avoidance/numbness symptoms in the three symptom groups was (9.21±3.39), the two items with the highest scores were repeated recall of traumatic events (1.57±0.71) and impaired concentration (1.47±0.71). Females scored higher than males on the increased alertness dimension(6.82±2.61,6.67±2.72) ( t = -6.49 , P <0.05). In respect to PCL-C total scores and the scores of each dimension, rural areas were associated with higher scores than urban areas, and non medical students scored higher than medical students, while the scores of those who grew up with siblings were higher than only children ( P <0.05). There was a significant positive correlation between an anti epidemic mentality and total PTSD scores ( r =0.51, P <0.01). Multiple regression analysis showed that the place of origin, choice of college major, and antiepidemic mentality were predictors of PTSD symptoms ( P <0.01).@*Conclusion@#Anti epidemic mentality is associated with the occurrence of PTSD among college students.
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Objective@#To investigate the effectiveness of solution focused brief therapy(SFBT) for adolescents with family post traumatic stress disorder(PTSD), and to provide a reference for the mental intervention for adolescents of PSTD.@*Methods@#From January 2017 to June 2018, 42 cases of PTSD adolescents with family trauma were randomly divided into observation group and control group, with 21 cases in each group; 21 healthy adolescents were enrolled as healthy group. The scores of Essen Trauma Inventor for children and adolescents(ETI-CA), Rosenberg Self Esteem Scale(RSES), Self Consistency and Congruence Scale(SCCS) and Mental Health Test(MHT) were evaluated. The observation group received SFBT intervention 6 times, the control group received no special intervention. The scores of the three groups were compared.@*Results@#Before the intervention, the RSES scores of the observation group and the control group were(26.68±3.12) and(27.58±3.72), significantly lower than(31.25±6.73) of the healthy group( F =13.63, P <0.05); the SCCS score was(109.89±21.85) and(108.60±20.46), significantly higher than(78.21±15.71) of the healthy group( F =12.69, P <0.05); The ETI CA scores was(28.10±8.12) and(27.98±7.89), significantly higher than(12.02± 2.13 ) of the healthy group( F =13.62, P <0.05); The MHT scores was(25.20±6.81) and(25.03±6.64), significantly higher than(17.55±4.69) of the healthy group( F =11.90, P <0.05). After intervention, the RSES score of the observation group was(31.31± 4.65 ), significantly higher than(28.04±4.11) of the control group( P <0.05); The ETI-CA, SCCS and MHT scores of the observation group were respectively(14.95±2.03)(96.66±17.02) and(18.55±5.17), significantly lower than(26.57±7.34)( 111.29 ±21.71) and(25.81±7.12) of the control group( P <0.05).@*Conclusion@#SFBT intervention can reduce PTSD level in adolescents with family PTSD, improve self esteem, self harmony and mental health.
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By summarizing and analizing the relevant literature of modern special acupuncture method in clinic treating posttraumatic stress disorder (PTSD), this paper aims to provide a reference for acupuncture and moxibustion in the era of post epidemic situation. At present, there are four major specific acupuncture treatments which include: Anshen- Xingnao- Tiaoshen Method, Tongdu- Tiaoshen Method, Shugan- Tiaoshen Method, Wentong Method. Although there are some differences in diagnosis, treatment ideas, meridian and acupoint selection and operation methods, the diagnosis and treatment ideas are mainly focusing on regulating the spirit and soothing the liver. The rules of selecting meridians and acupoints are Nao-acupoints, soothing Liver-qi, regulating mind and strengthening the spleen and kidney. Electric acupuncture is used more offen, but pure acupuncture treatment is used more less.